Community Based Outpatient Clinic ... - Veterans Affairs
Department of Veterans Affairs Office of Inspector General
Office of Healthcare Inspections Report No. 12-00577-273
Community Based Outpatient
Clinic Reviews
Wilmington, NC
Columbus, GA
Goose Creek, SC
Savannah, GA
September 7, 2012
Washington, DC 20420
Why We Did This Review
The VA OIG is undertaking a systematic review of the VHA's CBOCs to assess whether CBOCs are operated in a manner that provides veterans with consistent, safe, high-quality health care.
The Veterans' Health Care Eligibility Reform Act of 1996 was enacted to equip VA with ways to provide veterans with medically needed care in a more equitable and cost-effective manner. As a result, VHA expanded the Ambulatory and Primary Care Services to include CBOCs located throughout the United States. CBOCs were established to provide more convenient access to care for currently enrolled users and to improve access opportunities within existing resources for eligible veterans not currently served.
Veterans are required to receive one standard of care at all VHA health care facilities. Care at CBOCs needs be consistent, safe, and of high quality, regardless of model (VA-staffed or contract). CBOCs are expected to comply with all relevant VA policies and procedures, including those related to quality, patient safety, and performance.
To Report Suspected Wrongdoing in VA Programs and Operations Telephone: 1-800-488-8244 E-Mail: vaoighotline@
(Hotline Information: )
Wilmington, Columbus, Goose Creek, and Savannah
Glossary
ADA
Americans with Disabilities Act
CAVHCS
Central Alabama Veterans Health Care System
C&P
credentialing and privileging
CBOC
community based outpatient clinic
CCHT
Care Coordination Home Telehealth
CPRS
Computerized Patient Record System
Consult & TX Consult & Treatment
DM
Diabetes Mellitus
DX & TX Plan Diagnosis & Treatment Plan
ED
emergency department
EKG
electrocardiogram
EOC
environment of care
FPPE
Focused Professional Practice Evaluation
FTE
full-time employee equivalents
FY
fiscal year
HF
heart failure
IT
information technology
LCSW
licensed clinical social worker
LIP
licensed independent practitioner
MedMgt
medication management
MH
mental health
MHICM
mental health intensive case management
MST
military sexual trauma
NP
nurse practitioner
OIG
Office of Inspector General
OPPE
Ongoing Professional Practice Evaluation
PA
physician assistant
PCP
primary care provider
PII
personally identifiable information
PTSD
Post-Traumatic Stress Disorder
Qtr
quarter
TX
treatment
VAMC
VA Medical Center
VHA
Veterans Health Administration
VISN
Veterans Integrated Service Network
VistA
Veterans Health Information Systems and Technology Architecture
VA OIG Office of Healthcare Inspections
Wilmington, Columbus, Goose Creek, and Savannah
Table of Contents
Page
Executive Summary ................................................................................................... i
Objectives and Scope ................................................................................................ 1
Objectives ............................................................................................................... 1
Scope...................................................................................................................... 1
CBOC Characteristics................................................................................................ 2
MH Characteristics..................................................................................................... 3
Results and Recommendations ................................................................................ 4
Management of DM?Lower Limb Peripheral Vascular Disease .............................. 4
Women's Health...................................................................................................... 5
C&P ........................................................................................................................ 6
Environment and Emergency Management ............................................................ 9
HF Follow-Up .......................................................................................................... 12
Appendixes A. HF Follow-Up Results........................................................................................ 13
B. VISN 6 Director Comments ............................................................................... 15
C. Fayetteville VAMC Director Comments ............................................................. 16
D. VISN 7 Director Comments ............................................................................... 18
E. CAVHCS Director Comments............................................................................ 19
F. Ralph H. Johnson VAMC Director Comments ................................................... 23
G. OIG Contact and Staff Acknowledgments ......................................................... 26
H. Report Distribution............................................................................................. 27
VA OIG Office of Healthcare Inspections
Wilmington, Columbus, Goose Creek, and Savannah
Executive Summary
Purpose: We conducted an inspection of four CBOCs during the weeks of June 18
and 25, 2012. We evaluated select activities to assess whether the CBOCs operated in a manner that provides veterans with consistent, safe, high-quality health care. Table 1 lists the sites inspected.
VISN 6
7
Facility
CBOC
Fayetteville VAMC Central Alabama Veterans Health Care System
Ralph H. Johnson VAMC
Wilmington Columbus Goose Creek Savannah
Table 1. Sites Inspected
Recommendations: The VISN and Facility Directors, in conjunction with the
respective CBOC managers, should take appropriate actions to:
Fayetteville VAMC
Ensure that the doorbell at the entrance to the Wilmington CBOC is operational and routinely tested.
Ensure that all pictures at the Wilmington CBOC are secured and have acceptable safety covering.
Ensure that auditory privacy at the Wilmington CBOC is maintained during the check-in process.
CAVHCS
Ensure that Columbus CBOC clinicians document a risk level for diabetic patients in CPRS in accordance with VHA policy.
Ensure that patients with normal mammogram results are notified of results within the allotted timeframe and that notification is documented in the medical record at the Columbus CBOC.
Ensure providers are granted privileges that are consistent with the services provided at the Columbus CBOC.
Ensure that Primary Care service-specific competency criteria is created, approved, and implemented.
Ensure that Service Chief, Credentialing Board, and/or medical staff's Executive Committee list documents reviewed and the rationale for conclusions reached for privileging LIPs at the Columbus CBOC.
VA OIG Office of Healthcare Inspections
i
................
................
In order to avoid copyright disputes, this page is only a partial summary.
To fulfill the demand for quickly locating and searching documents.
It is intelligent file search solution for home and business.
Related searches
- department of veterans affairs resume
- veterans affairs outlook web access
- veterans affairs outlook webmail
- veterans affairs employee email access
- my pay veterans affairs employees
- department of veterans affairs fms
- veterans affairs email access
- dept veterans affairs co pay
- veterans affairs webmail access
- veterans affairs email directory
- veterans affairs intranet for employees
- veterans affairs employee directory